This study focused on identification of mobilization initiatives for enhancing student’s enrolment into Vocational and Technical Education (VTE) programs in Nigerian Universities. Three research questions guided the ...This study focused on identification of mobilization initiatives for enhancing student’s enrolment into Vocational and Technical Education (VTE) programs in Nigerian Universities. Three research questions guided the study while three hypotheses were formulated and tested at 0.05 level of significance. The study was carried out in South East, Nigeria. Population for the study was 1340. Sample for the study was 753 obtained through proportionate (30%) stratified random sampling technique. A 38 item questionnaire was developed and used to collect data. Data obtained were analyzed using mean and standard deviation to answer research questions while t-test statistic was used to test hypotheses at probability of 0.05 level. It was found out by the study that 38 mobilization initiatives could be used to enhance students’ enrolment into Vocational and Technical Education Programs in Nigerian Universities. It was therefore recommended that the identified mobilization initiatives be implemented by relevant stakeholders to enhance secondary school students’ enrollment into VTE programs in Nigerian Universities.展开更多
In recent years,a wide variety of fuzzy time series(FTS)forecasting models have been created and recommended to handle the complicated and ambiguous challenges relating to time series data from real-world sources.Howe...In recent years,a wide variety of fuzzy time series(FTS)forecasting models have been created and recommended to handle the complicated and ambiguous challenges relating to time series data from real-world sources.However,the accuracy of a model is problem-specific and varies across data sets.But a model’s precision varies between different data sets and depends on the situation at hand.Even though many models assert that they are better than statistics and a single machine learning-based model,increasing forecasting accuracy is still a challenging task.In the fuzzy time series models,the size of the intervals and the fuzzy relationship groups are thought to be crucial variables that affect the model’s forecasting abilities.This study offers a hybrid FTS forecasting model that makes use of both the graph-based clustering technique(GBC)and particle swarm optimization(PSO)for adjusting interval lengths in the universe of discourse(UoD).The suggested model’s forecasting results have been compared to those provided by other current models on a dataset of enrollments at the University of Alabama.For all orders of fuzzy relationships,the suggested model outperforms its counterparts in terms of forecasting accuracy.展开更多
Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical cen...Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical center. Every study differs in various aspects, such as phases, study indication, eligibility criteria, etc. In terms of meeting the enrollment deadline, typically, the study indication and availability of the patient’s population at the geographical area of the research site would decide if the trial could be time-consuming. Patient recruitment and retention are critical for the success of every clinical trial;however, worldwide, this area is facing tremendous pressure and challenges. Globally 55% of clinical trials terminated due to low recruitment, with an average enrollment success rate of 40% for Phase III and IV trials. Over 80% of clinical trial attempts fail to enroll, extending the study and adding new study sites. In the United States, more than 80% of clinical trials fail to achieve targeted patient enrollment, and 30% of study participants discontinue participation. This article reviewed various factors hindering clinical trial recruitment and retention and suggested strategies to make the research site successful.展开更多
Major diversion is an important part of the large-category student enrollment and training model.The degree to which undergraduates recognize the logic of the major diversion system,their satisfaction with the diverte...Major diversion is an important part of the large-category student enrollment and training model.The degree to which undergraduates recognize the logic of the major diversion system,their satisfaction with the diverted major,and their major identity after diversion all influence their subsequent learning process and outcomes.The questionnaire survey of undergraduates in this study discovered that major diversion attitude has a significant positive effect on undergraduates'learning gains;the mediating effect test discovered that course perception plays a partially mediating role between major diversion attitude and learning gains.Therefore,under the large-category student enrollment and training model,it is necessary to improve the major diversion system in terms of formulation,major selection guidance,and major identity promotion.Furthermore,strengthening the logical connection and content coupling of different types of courses,dealing with the proportion,priority,and sequence of courses,optimizing the allocation of course resources,and reasonably planning and setting courses all play an important role in improving undergraduate learning gains.展开更多
There is a growing body of literature that recognizes the importance of data mining in educational systems. This recognition makes educational data mining a new growing research community. One way to achieve the highe...There is a growing body of literature that recognizes the importance of data mining in educational systems. This recognition makes educational data mining a new growing research community. One way to achieve the highest level of quality in a higher education system is by discovering knowledge from educational data such as students’ enrollment data. Many mining tools that aim to discover exciting correlations, frequent patterns, associations, or casual structures among sets of items in educational data sets have been proposed. One of the widely used tools is association rules. In this paper, the Apriori algorithm is used to generate association rules to discover the importance and correlation between factors that influence student’s decision to enroll in higher education institutions in Sudan. The algorithm is applied using a student’s enrollment data set that was created using a questionnaire and 800 students enrolled in governmental and private sector universities as a sample. This paper classifies factors that influence enrollment into: student’s demographic factors and four categories of enrollment related factors (Student and Society, Educational Institution, Admission, and Employment related factors), and determines the most influential factors in determining student’s decision to enroll in Sudanese universities. The analysis result shows that the Educational Institution related factors (50%) and Admission related factors (40%) are strongly influencing students’ enrollment decision, while the Employment related factors (10%) and Student and Society related factors (0%) have weak influence. The factors out of the 14 Educational Institution related factors that have a high impact are: reputation, diversity of study, quality of education, education facilities, and feasibility.展开更多
Background and Purpose:To determine the relationship between ulceration, thro mbus, and calcification of carotid artery atherosclerotic plaques and symptoms o f ipsilateral or contralateral stroke. Methods:We compared...Background and Purpose:To determine the relationship between ulceration, thro mbus, and calcification of carotid artery atherosclerotic plaques and symptoms o f ipsilateral or contralateral stroke. Methods:We compared microscopic plaque m orphology from patients with and without stroke symptoms ipsilateral or contrala teral to the plaque. Plaques were characterized for ulceration, thrombus, and ca lcification. We analyzed plaques from 241 subjects: 170 patients enrolled in the Asymptomatic Carotid Atherosclerosis Study (ACAS) and 71 patients enrolled in t he North American Symptomatic Carotid Endarterectomy Trial (NASCET); 128 subject s had no history of stroke symptoms, 80 subjects had ipsilateral symptoms, and 3 3 had contralateral symptoms. Results:Plaque ulceration was more common in plaq ues taken from symptomatic patients than those without symptoms (36%versus 14% ; P < 0.001); frequency of ulceration was similar for plaques associated with ip silateral(34%) and contralateral (42%) symptoms. Thrombus was most common in p laques taken from patients with both ipsilateral symptoms and ulceration. The ex tent of calcification was unassociated with stroke symptoms. Conclusion:Carotid plaque ulceration and thrombosis are more prevalent in symptomatic patients. Ul ceration is more common in symptomatic patients regardless of side of carotid sy mptoms, whereas thrombus is associated with ipsilateral symptoms and plaque ulce ration.Preoperative identification of carotid ulceration and thrombus should lea d to greater efficacy of stroke prevention by carotid endarterectomy.展开更多
The enrollment expansion of higher vocational education is not only a strategic measure to alleviate the structural contradiction of employment,but also an important support for economic transformation and upgrading.H...The enrollment expansion of higher vocational education is not only a strategic measure to alleviate the structural contradiction of employment,but also an important support for economic transformation and upgrading.How to deal with the expansion of enrollment and ensure the quality of training is an important task of higher vocational colleges at this stage.Based on the development requirements of the new era,it is of great practical significance to build a perfect quality assurance system of talent training.展开更多
Many forecasting models based on the concepts of Fuzzy time series have been proposed in the past decades. These models have been widely applied to various problem domains, especially in dealing with forecasting probl...Many forecasting models based on the concepts of Fuzzy time series have been proposed in the past decades. These models have been widely applied to various problem domains, especially in dealing with forecasting problems in which historical data are linguistic values. In this paper, we present a new fuzzy time series forecasting model, which uses the historical data as the universe of discourse and uses the K-means clustering algorithm to cluster the universe of discourse, then adjust the clusters into intervals. The proposed method is applied for forecasting University enrollment of Alabama. It is shown that the proposed model achieves a significant improvement in forecasting accuracy as compared to other fuzzy time series forecasting models.展开更多
It has been approximately six and one-half yearssince the first patient was enrolled in a gene therapyclinical trial. Since that important begining, this typeof genetic intervention has grown into a worldwideinvestiga...It has been approximately six and one-half yearssince the first patient was enrolled in a gene therapyclinical trial. Since that important begining, this typeof genetic intervention has grown into a worldwideinvestigative activity involving about 2100 patients asof December 1996. Although it was initially展开更多
Objective To study the feasibility of enforcing immunization certificate check before children enroll in primary schools or kindergartens in Guizhou Province. Methods Quantitative and qualitative studies were conducte...Objective To study the feasibility of enforcing immunization certificate check before children enroll in primary schools or kindergartens in Guizhou Province. Methods Quantitative and qualitative studies were conducted. The multi-stage and cluster sampling approach was adopted for the quantitative part of the study. A questionnaire was designed and 996 children and their keepers were interviewed. Principals, doctors or teachers of the primary schools, directors and child care nurses of kindergarten, and staff of immunization agencies were invited to take part in 12 focus group discussions; meanwhile, face-to-face individual in-depth interviews with 16 officials of the Health, Education and Governmental Departments at various levels were conducted. Results The total number of subjects was 996. 16.7% of the children in the study completed all the procedures of the National Immunization Programme. 34.3% of them had immunization certificates while the remainder 44.7% registered in immunization agencies. Factors, including the migrant children, doubt about vaccine efficiency, mother’s occupation and educational background, knowledge of the National Immunization Programme on targeted vaccines, played an important role in obtaining or not immunization certificates. 95% of the keepers interviewed thought the immunization certificates were useful; 94.8% of them considered the check was critical while only 3.6% of them thought it unnecessary. The first reason from those who found it unnecessary was that they feared that repeated immunization might affect their children’s health. The second reason was the cost of immunization, which some of them could not afford to pay. However, the Health Department expressed a favorable attitude to the checking scheme. Though the Education Department agreed that the scheme was essential, they worried that it would affect the enrollment rate.Conclusion In spite of the difficulty in administering immunization certificate check, the effort would be rewarding for raising the immunization coverage rate among the children in Guizhou Province.展开更多
In August 2011,the Sangzhi County government,Hunan Province,adopted a series of new health care policies as a national pilot of the New Cooperative Medical Scheme(referred to as 2011 NCMS).These policies were designed...In August 2011,the Sangzhi County government,Hunan Province,adopted a series of new health care policies as a national pilot of the New Cooperative Medical Scheme(referred to as 2011 NCMS).These policies were designed to further resolve illness-led poverty and the poor state of health care in the local area.The program had a positive impact and spread to other regions in Hunan Province.This paper will discuss the progress made as a result of the policies and several issues that challenge the scheme in practice.A total sample of 1212 individuals and 303 households were included in the analysis,and98 interviews were conducted with people related to the scheme.Our major findings indicate that the 201!NCMS has significantly reduced the out-of-pocket medical payment of rural residents,and also increased the township hospitals'patient flow.However,the medical scheme still faces many challenging issues during the implementation.With the increasing interest among the Chinese policy makers in strengthening and promoting the Sangzhi Model,the impacts of the scheme deserve greater attention in practice so as to further improve NCMS in rural China.展开更多
Objectives To evaluate the feasibility, and immediate and mid-term outcomes of drug-eluting stents (DESs) in the treatment of coronary artery stenosis with very long defuse lesions(VLDL). Methods Inclusion criteria:
BACKGROUND There is an acute need to raise awareness of non-alcoholic fatty liver disease/nonalcoholic steatohepatitis(NAFLD/NASH)among primary care physicians,endocrinologists and diabetologists to improve patient id...BACKGROUND There is an acute need to raise awareness of non-alcoholic fatty liver disease/nonalcoholic steatohepatitis(NAFLD/NASH)among primary care physicians,endocrinologists and diabetologists to improve patient identification and address the current difficulties in NASH clinical trial enrollment.We examined the extent of knowledge and practice regarding NASH diagnosis and management guidelines.A randomized online convenience survey of 12869 physicians drawn from a national physician database of primary care physicians(PCPs),and gastroenterology and endocrinology specialists were queried via online survey.Our results,based on a cohort of 185 respondents,showed gaps in knowledge and practice between these three groups of practitioners,with primary care providers having the lowest adherence to published guidelines for diagnosis of NASH.Without clear knowledge and patient identification at the point of presentation-which is often in primary care or with specialties other than hepatology–many patients with NAFLD and NASH will remain undiagnosed and untreated,and clinical studies will continue to struggle with patient recruitment,hindering clinical development and optimal patient care.AIM To determine knowledge base concerning NASH diagnosis amongst gastroenterologists,endocrinologists and primary care physicians to improve referrals into clinical trials.METHODS A randomized online convenience survey of 12869 physicians drawn from a national physician database of PCPs,and gastroenterology and endocrinology specialists was conducted yielding a sample of 185 respondents.RESULTS The survey revealed that many physicians are either unaware of testing options other than biopsy,or do not use them in practice.Only 46%of endocrinologists and 42%of primary care physicians indicated they would refer a patient for specialist workup if they suspected NASH.Risk(25%)and inconvenience to patients(18%)are given as reasons for not referring those with suspected NASH for biopsy.For standard diagnostic algorithms such as Fibrosis-4 score,18%of PCPs,30%of endocrinologists and 65%gastroenterologists reported using these tests in clinical practice.CONCLUSION Substantial gaps in knowledge of the differences between NAFLD and NASH exist between these physician groups,with knowledge being particularly low among primary care doctors and endocrinologists.The use of a simple noninvasive screening algorithm may help to identify the right patients for clinical trials,which in turn will be vital to the development of effective and welltolerated treatments for this increasingly ubiquitous condition.展开更多
Base on the folk secret formula, the medical personals have developed Qu Feng Powder (祛风散) and Qu Feng Pills (祛风丸) which are made from pure Chinese herbs, indicated for rheumatic diseases, hyperosteopeny, and pr...Base on the folk secret formula, the medical personals have developed Qu Feng Powder (祛风散) and Qu Feng Pills (祛风丸) which are made from pure Chinese herbs, indicated for rheumatic diseases, hyperosteopeny, and protrusion of intervertebral disc, etc. In the training course, you can learn the pathogenic mechanism, diagnosis and treatment based on TCM differentiation of syndromes, and preparation of the above drugs. For further details and application form, please contact with the Training school.Address: Training School of Rheumatism, Julu County 055250, Hebei Province, P. R. ChinaTel:展开更多
It is evident that both recruitment and retention play critical roles in clinical trials. Recruitment and retention models are beginning to be analyzed worldwide in an effort to assess how to conduct studies more effi...It is evident that both recruitment and retention play critical roles in clinical trials. Recruitment and retention models are beginning to be analyzed worldwide in an effort to assess how to conduct studies more efficiently, all the while, allowing researchers to provide sound and ethical data to help advance medicine through clinical studies. Sponsors and sites have recognized that clinical trial enrollment must become more diverse and inclusive. In this review, we address the important topics of recruitment and retention in clinical trials. Specifically, the obstacles in regard to recruiting vulnerable populations. Methodologies to improve both the understanding of the study population and community engagement are outlined. In particular, newer strategies such as use of social media and more reliable strategies such as trust and relationship building are described in detail. A strong focus on recruitment is becoming widely recognized as being of such importance that consideration is given to this key component even during initial protocol development. Attention to recruitment and retention in the strategic planning process of clinical trials can mitigate enrollment issues that clinical researchers are experiencing.展开更多
Credit bank system is a very important management mode in current higher vocational education,and it is also an important means for the Ministry of Education to promote China's modern education reform.This paper c...Credit bank system is a very important management mode in current higher vocational education,and it is also an important means for the Ministry of Education to promote China's modern education reform.This paper combines the specific background of higher vocational enrollment expansion,expounds the practical significance of the credit bank system in the training of the expanded enrollment talents,and explores the methods and rules of the authentication and transformation of the learning achievement of the expanded enrollment students under the system.In order to achieve convergence of different types of learning results,smooth talent growth channel,a useful exploration is carried out.展开更多
Thundrup Tsering.Thundrup Tsering is a second-class performer,a member of the Chinese Musicians’Association,a council member of the China Minority Vocal Music Association,and deputy head of the Tibet Song and Dance E...Thundrup Tsering.Thundrup Tsering is a second-class performer,a member of the Chinese Musicians’Association,a council member of the China Minority Vocal Music Association,and deputy head of the Tibet Song and Dance Ensemble.Thundrup Tsering was enrolled by the Shanghai Conservatory of Music in 1975,studying under Professor Wang Pinsu.Upon graduation he became a solo singer of the Tibet Song展开更多
文摘This study focused on identification of mobilization initiatives for enhancing student’s enrolment into Vocational and Technical Education (VTE) programs in Nigerian Universities. Three research questions guided the study while three hypotheses were formulated and tested at 0.05 level of significance. The study was carried out in South East, Nigeria. Population for the study was 1340. Sample for the study was 753 obtained through proportionate (30%) stratified random sampling technique. A 38 item questionnaire was developed and used to collect data. Data obtained were analyzed using mean and standard deviation to answer research questions while t-test statistic was used to test hypotheses at probability of 0.05 level. It was found out by the study that 38 mobilization initiatives could be used to enhance students’ enrolment into Vocational and Technical Education Programs in Nigerian Universities. It was therefore recommended that the identified mobilization initiatives be implemented by relevant stakeholders to enhance secondary school students’ enrollment into VTE programs in Nigerian Universities.
基金the support of Thai Nguyen University of Technology(TNUT)to this research.
文摘In recent years,a wide variety of fuzzy time series(FTS)forecasting models have been created and recommended to handle the complicated and ambiguous challenges relating to time series data from real-world sources.However,the accuracy of a model is problem-specific and varies across data sets.But a model’s precision varies between different data sets and depends on the situation at hand.Even though many models assert that they are better than statistics and a single machine learning-based model,increasing forecasting accuracy is still a challenging task.In the fuzzy time series models,the size of the intervals and the fuzzy relationship groups are thought to be crucial variables that affect the model’s forecasting abilities.This study offers a hybrid FTS forecasting model that makes use of both the graph-based clustering technique(GBC)and particle swarm optimization(PSO)for adjusting interval lengths in the universe of discourse(UoD).The suggested model’s forecasting results have been compared to those provided by other current models on a dataset of enrollments at the University of Alabama.For all orders of fuzzy relationships,the suggested model outperforms its counterparts in terms of forecasting accuracy.
文摘Enrolling in clinical trials could be time-sensitive and time-demanding tasks for the research site, especially if it is a private research organization compared to the research conducted at an academic or medical center. Every study differs in various aspects, such as phases, study indication, eligibility criteria, etc. In terms of meeting the enrollment deadline, typically, the study indication and availability of the patient’s population at the geographical area of the research site would decide if the trial could be time-consuming. Patient recruitment and retention are critical for the success of every clinical trial;however, worldwide, this area is facing tremendous pressure and challenges. Globally 55% of clinical trials terminated due to low recruitment, with an average enrollment success rate of 40% for Phase III and IV trials. Over 80% of clinical trial attempts fail to enroll, extending the study and adding new study sites. In the United States, more than 80% of clinical trials fail to achieve targeted patient enrollment, and 30% of study participants discontinue participation. This article reviewed various factors hindering clinical trial recruitment and retention and suggested strategies to make the research site successful.
文摘Major diversion is an important part of the large-category student enrollment and training model.The degree to which undergraduates recognize the logic of the major diversion system,their satisfaction with the diverted major,and their major identity after diversion all influence their subsequent learning process and outcomes.The questionnaire survey of undergraduates in this study discovered that major diversion attitude has a significant positive effect on undergraduates'learning gains;the mediating effect test discovered that course perception plays a partially mediating role between major diversion attitude and learning gains.Therefore,under the large-category student enrollment and training model,it is necessary to improve the major diversion system in terms of formulation,major selection guidance,and major identity promotion.Furthermore,strengthening the logical connection and content coupling of different types of courses,dealing with the proportion,priority,and sequence of courses,optimizing the allocation of course resources,and reasonably planning and setting courses all play an important role in improving undergraduate learning gains.
文摘There is a growing body of literature that recognizes the importance of data mining in educational systems. This recognition makes educational data mining a new growing research community. One way to achieve the highest level of quality in a higher education system is by discovering knowledge from educational data such as students’ enrollment data. Many mining tools that aim to discover exciting correlations, frequent patterns, associations, or casual structures among sets of items in educational data sets have been proposed. One of the widely used tools is association rules. In this paper, the Apriori algorithm is used to generate association rules to discover the importance and correlation between factors that influence student’s decision to enroll in higher education institutions in Sudan. The algorithm is applied using a student’s enrollment data set that was created using a questionnaire and 800 students enrolled in governmental and private sector universities as a sample. This paper classifies factors that influence enrollment into: student’s demographic factors and four categories of enrollment related factors (Student and Society, Educational Institution, Admission, and Employment related factors), and determines the most influential factors in determining student’s decision to enroll in Sudanese universities. The analysis result shows that the Educational Institution related factors (50%) and Admission related factors (40%) are strongly influencing students’ enrollment decision, while the Employment related factors (10%) and Student and Society related factors (0%) have weak influence. The factors out of the 14 Educational Institution related factors that have a high impact are: reputation, diversity of study, quality of education, education facilities, and feasibility.
文摘Background and Purpose:To determine the relationship between ulceration, thro mbus, and calcification of carotid artery atherosclerotic plaques and symptoms o f ipsilateral or contralateral stroke. Methods:We compared microscopic plaque m orphology from patients with and without stroke symptoms ipsilateral or contrala teral to the plaque. Plaques were characterized for ulceration, thrombus, and ca lcification. We analyzed plaques from 241 subjects: 170 patients enrolled in the Asymptomatic Carotid Atherosclerosis Study (ACAS) and 71 patients enrolled in t he North American Symptomatic Carotid Endarterectomy Trial (NASCET); 128 subject s had no history of stroke symptoms, 80 subjects had ipsilateral symptoms, and 3 3 had contralateral symptoms. Results:Plaque ulceration was more common in plaq ues taken from symptomatic patients than those without symptoms (36%versus 14% ; P < 0.001); frequency of ulceration was similar for plaques associated with ip silateral(34%) and contralateral (42%) symptoms. Thrombus was most common in p laques taken from patients with both ipsilateral symptoms and ulceration. The ex tent of calcification was unassociated with stroke symptoms. Conclusion:Carotid plaque ulceration and thrombosis are more prevalent in symptomatic patients. Ul ceration is more common in symptomatic patients regardless of side of carotid sy mptoms, whereas thrombus is associated with ipsilateral symptoms and plaque ulce ration.Preoperative identification of carotid ulceration and thrombus should lea d to greater efficacy of stroke prevention by carotid endarterectomy.
文摘The enrollment expansion of higher vocational education is not only a strategic measure to alleviate the structural contradiction of employment,but also an important support for economic transformation and upgrading.How to deal with the expansion of enrollment and ensure the quality of training is an important task of higher vocational colleges at this stage.Based on the development requirements of the new era,it is of great practical significance to build a perfect quality assurance system of talent training.
文摘Many forecasting models based on the concepts of Fuzzy time series have been proposed in the past decades. These models have been widely applied to various problem domains, especially in dealing with forecasting problems in which historical data are linguistic values. In this paper, we present a new fuzzy time series forecasting model, which uses the historical data as the universe of discourse and uses the K-means clustering algorithm to cluster the universe of discourse, then adjust the clusters into intervals. The proposed method is applied for forecasting University enrollment of Alabama. It is shown that the proposed model achieves a significant improvement in forecasting accuracy as compared to other fuzzy time series forecasting models.
文摘目的腹腔镜辅助手术和多重管理方案(即加速康复程序,Enhanced Recovery Program,ERP)极大地改变了结直肠癌患者的围手术期管理,并改善了临床治疗结局。然而,腹腔镜手术尚未成为世界范围内结直肠癌手术治疗的标准,大量有着良好开腹手术技术的外科医生仍采用传统手术方式治疗。究竟传统开腹手术辅助ERP能否与腹腔镜辅助的微创治疗匹敌?这一问题还存在争议。EnROL(Enhanced Recovery Open versus Laparoscopic)多中心随机对照试验旨在解答上述问题。资料和方法该研究为Ⅲ期多中心随机对照临床试验,纳入可择期手术的成年结直肠癌患者(年龄≥18岁),按1∶1随机分配至腹腔镜组或开腹组,两组均应用快速康复多重管理程序(ERP)进行围手术期管理。通过纳入中心、肿瘤部位(结肠或直肠)、年龄组(〈66/66~75/〉75岁)再进行分层分析。研究的主要结局指标为术后1个月的机体疲劳感(使用多维疲劳量表MFI-20评价),次要结局指标包括:住院时间、术后并发症、患者其他不适情况及身体机能(简表SF-36)。术后7天或更早出院之前,受试患者和结局评估人员都不知晓治疗情况。手术质量及病理评估由中心负责人员进行盲评。该研究在英国临床伦理委员会南部牛津中心B注册,注册号为No.07/H0605/150。结果研究从2008年7月开始,至2012年4月结束,共在英国的12个中心纳入204例病人(其中腹腔镜组103人,开放结合ERP组101人)。腹腔组的切除范围[(6.8±3.7)vs.(18.4±7.5)cm]以及术中出血量[(115±152)vs.(257±290)ml]较开腹组减少,但手术时间[(182±69)vs.(135±54)min]相对延长,总体手术相关损伤评分[(31.2±6.0)vs.(31.8±6.0)]没有明显差别。两组病人术后1个月的机体疲劳感评分无显著差异[MFI-20(12.28,95%CI:11.3~13.1)vs.(12.05,95%CI:11.2~13.1);P=0.93]。然而,腹腔镜组的中位住院时间较开腹组明显缩短(5 vs.7天;四分位点间距:4~9 vs.5~11天;P=0.033)。其他次要结局和病理报告质量均未见显著差异。结论虽然有经验的外科医生运用开腹手术结合加速康复程序可使结直肠癌患者术后疲乏感及其他不适情况降低至腹腔镜手术治疗相当的水平,但是住院时间会有明显的延长。在治疗结局无明显差别的前提下,腹腔镜辅助结直肠癌手术结合快速康复程序更应被推广使用。
文摘It has been approximately six and one-half yearssince the first patient was enrolled in a gene therapyclinical trial. Since that important begining, this typeof genetic intervention has grown into a worldwideinvestigative activity involving about 2100 patients asof December 1996. Although it was initially
文摘Objective To study the feasibility of enforcing immunization certificate check before children enroll in primary schools or kindergartens in Guizhou Province. Methods Quantitative and qualitative studies were conducted. The multi-stage and cluster sampling approach was adopted for the quantitative part of the study. A questionnaire was designed and 996 children and their keepers were interviewed. Principals, doctors or teachers of the primary schools, directors and child care nurses of kindergarten, and staff of immunization agencies were invited to take part in 12 focus group discussions; meanwhile, face-to-face individual in-depth interviews with 16 officials of the Health, Education and Governmental Departments at various levels were conducted. Results The total number of subjects was 996. 16.7% of the children in the study completed all the procedures of the National Immunization Programme. 34.3% of them had immunization certificates while the remainder 44.7% registered in immunization agencies. Factors, including the migrant children, doubt about vaccine efficiency, mother’s occupation and educational background, knowledge of the National Immunization Programme on targeted vaccines, played an important role in obtaining or not immunization certificates. 95% of the keepers interviewed thought the immunization certificates were useful; 94.8% of them considered the check was critical while only 3.6% of them thought it unnecessary. The first reason from those who found it unnecessary was that they feared that repeated immunization might affect their children’s health. The second reason was the cost of immunization, which some of them could not afford to pay. However, the Health Department expressed a favorable attitude to the checking scheme. Though the Education Department agreed that the scheme was essential, they worried that it would affect the enrollment rate.Conclusion In spite of the difficulty in administering immunization certificate check, the effort would be rewarding for raising the immunization coverage rate among the children in Guizhou Province.
文摘In August 2011,the Sangzhi County government,Hunan Province,adopted a series of new health care policies as a national pilot of the New Cooperative Medical Scheme(referred to as 2011 NCMS).These policies were designed to further resolve illness-led poverty and the poor state of health care in the local area.The program had a positive impact and spread to other regions in Hunan Province.This paper will discuss the progress made as a result of the policies and several issues that challenge the scheme in practice.A total sample of 1212 individuals and 303 households were included in the analysis,and98 interviews were conducted with people related to the scheme.Our major findings indicate that the 201!NCMS has significantly reduced the out-of-pocket medical payment of rural residents,and also increased the township hospitals'patient flow.However,the medical scheme still faces many challenging issues during the implementation.With the increasing interest among the Chinese policy makers in strengthening and promoting the Sangzhi Model,the impacts of the scheme deserve greater attention in practice so as to further improve NCMS in rural China.
文摘Objectives To evaluate the feasibility, and immediate and mid-term outcomes of drug-eluting stents (DESs) in the treatment of coronary artery stenosis with very long defuse lesions(VLDL). Methods Inclusion criteria:
文摘BACKGROUND There is an acute need to raise awareness of non-alcoholic fatty liver disease/nonalcoholic steatohepatitis(NAFLD/NASH)among primary care physicians,endocrinologists and diabetologists to improve patient identification and address the current difficulties in NASH clinical trial enrollment.We examined the extent of knowledge and practice regarding NASH diagnosis and management guidelines.A randomized online convenience survey of 12869 physicians drawn from a national physician database of primary care physicians(PCPs),and gastroenterology and endocrinology specialists were queried via online survey.Our results,based on a cohort of 185 respondents,showed gaps in knowledge and practice between these three groups of practitioners,with primary care providers having the lowest adherence to published guidelines for diagnosis of NASH.Without clear knowledge and patient identification at the point of presentation-which is often in primary care or with specialties other than hepatology–many patients with NAFLD and NASH will remain undiagnosed and untreated,and clinical studies will continue to struggle with patient recruitment,hindering clinical development and optimal patient care.AIM To determine knowledge base concerning NASH diagnosis amongst gastroenterologists,endocrinologists and primary care physicians to improve referrals into clinical trials.METHODS A randomized online convenience survey of 12869 physicians drawn from a national physician database of PCPs,and gastroenterology and endocrinology specialists was conducted yielding a sample of 185 respondents.RESULTS The survey revealed that many physicians are either unaware of testing options other than biopsy,or do not use them in practice.Only 46%of endocrinologists and 42%of primary care physicians indicated they would refer a patient for specialist workup if they suspected NASH.Risk(25%)and inconvenience to patients(18%)are given as reasons for not referring those with suspected NASH for biopsy.For standard diagnostic algorithms such as Fibrosis-4 score,18%of PCPs,30%of endocrinologists and 65%gastroenterologists reported using these tests in clinical practice.CONCLUSION Substantial gaps in knowledge of the differences between NAFLD and NASH exist between these physician groups,with knowledge being particularly low among primary care doctors and endocrinologists.The use of a simple noninvasive screening algorithm may help to identify the right patients for clinical trials,which in turn will be vital to the development of effective and welltolerated treatments for this increasingly ubiquitous condition.
文摘Base on the folk secret formula, the medical personals have developed Qu Feng Powder (祛风散) and Qu Feng Pills (祛风丸) which are made from pure Chinese herbs, indicated for rheumatic diseases, hyperosteopeny, and protrusion of intervertebral disc, etc. In the training course, you can learn the pathogenic mechanism, diagnosis and treatment based on TCM differentiation of syndromes, and preparation of the above drugs. For further details and application form, please contact with the Training school.Address: Training School of Rheumatism, Julu County 055250, Hebei Province, P. R. ChinaTel:
文摘It is evident that both recruitment and retention play critical roles in clinical trials. Recruitment and retention models are beginning to be analyzed worldwide in an effort to assess how to conduct studies more efficiently, all the while, allowing researchers to provide sound and ethical data to help advance medicine through clinical studies. Sponsors and sites have recognized that clinical trial enrollment must become more diverse and inclusive. In this review, we address the important topics of recruitment and retention in clinical trials. Specifically, the obstacles in regard to recruiting vulnerable populations. Methodologies to improve both the understanding of the study population and community engagement are outlined. In particular, newer strategies such as use of social media and more reliable strategies such as trust and relationship building are described in detail. A strong focus on recruitment is becoming widely recognized as being of such importance that consideration is given to this key component even during initial protocol development. Attention to recruitment and retention in the strategic planning process of clinical trials can mitigate enrollment issues that clinical researchers are experiencing.
文摘Credit bank system is a very important management mode in current higher vocational education,and it is also an important means for the Ministry of Education to promote China's modern education reform.This paper combines the specific background of higher vocational enrollment expansion,expounds the practical significance of the credit bank system in the training of the expanded enrollment talents,and explores the methods and rules of the authentication and transformation of the learning achievement of the expanded enrollment students under the system.In order to achieve convergence of different types of learning results,smooth talent growth channel,a useful exploration is carried out.
文摘Thundrup Tsering.Thundrup Tsering is a second-class performer,a member of the Chinese Musicians’Association,a council member of the China Minority Vocal Music Association,and deputy head of the Tibet Song and Dance Ensemble.Thundrup Tsering was enrolled by the Shanghai Conservatory of Music in 1975,studying under Professor Wang Pinsu.Upon graduation he became a solo singer of the Tibet Song